The burden of tuberculosis and attributable risk factors in Brazil, 1990–2017: results from the Global Burden of Disease Study 2017

Population Health Metrics

Mariângela Carneiro¹  Juliana Maria Trindade Bezerra¹  David Soeiro Barbosa¹  Francisco Rogerlândio Martins-Melo²  Antonio Luiz Pinho Ribeiro³  Mohsen Naghavi⁴  Guilherme Loureiro Werneck⁵  Kleydson Bonfim Andrade⁶ 

[1] Epidemiology of Infectious and Parasitic Diseases Laboratory, Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, 31270-901, Belo Horizonte, MG, Brazil;Federal Institute of Education, Science and Technology of Ceará, Rua Francisco da Rocha Martins, S/N, Pabussu, 61609-090, Caucaia, CE, Brazil;Hospital das Clínicas, Faculty of Medicine, Federal University of Minas Gerais, Avenida Prof. Alfredo Balena, 110, Santa Efigênia, 30130-100, Belo Horizonte, MG, Brazil;Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Avenue, Suite 600, 98121, Seattle, WA, USA;Institute of Studies in Public Health, Federal University of Rio de Janeiro, Avenida Horácio Macedo, S/N, Ilha do Fundão – Cidade Universitária, 21941-598, Rio de Janeiro, RJ, Brazil;Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rua São Francisco Xavier 524, Maracanã, 20550-013, Rio de Janeiro, RJ, Brazil;National Tuberculosis Programme, Department of Chronic Infectious Diseases and STI, Secretariat of Health Surveillance, Brazilian Ministry of Health, SRTVN, Quadra 701, Via W5 Norte, Lote D, Edifício PO700, 6° andar, Brasília, DF, Brazil;

关键词: Tuberculosis;    Burden of disease;    Disability-adjusted life year;    Brazil;   

DOI  :  10.1186/s12963-020-00203-6

来源: Springer

【 摘 要 】

BackgroundTuberculosis (TB) continues to be an important cause of fatal and non-fatal burden in Brazil. In this study, we present estimates for TB burden in Brazil from 1990 to 2017 using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017).MethodsThis descriptive study used GBD 2017 findings to report years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) of TB in Brazil by sex, age group, HIV status, and Brazilian states, from 1990 to 2017. We also present the TB burden attributable to independent risk factors such as smoking, alcohol use, and diabetes. Results are reported in absolute number and age-standardized rates (per 100,000 inhabitants) with 95% uncertainty intervals (UIs).ResultsIn 2017, the number of DALYs due to TB (HIV-negative and HIV-positive combined) in Brazil was 284,323 (95% UI: 240,269–349,265). Among HIV-negative individuals, the number of DALYs was 196,366 (95% UI: 189,645–202,394), while 87,957 DALYs (95% UI: 50,624–146,870) were estimated among HIV-positive individuals. Between 1990 and 2017, the absolute number and age-standardized rates of DALYs due to TB at the national level decreased by 47.0% and 68.5%, respectively. In 2017, the sex–age-specific TB burden was highest among males and in children under-1 year and the age groups 45–59 years. The Brazilian states with the highest age-standardized DALY rates in 2017 were Rio de Janeiro, Pernambuco, and Amazonas. Age-standardized DALY rates decreased for all 27 Brazilian states between 1990 and 2017. Alcohol use accounted for 47.5% of national DALYs due to TB among HIV-negative individuals in 2017, smoking for 17.9%, and diabetes for 7.7%.ConclusionsGBD 2017 results show that, despite the remarkable progress in reducing the DALY rates during the period, TB remains as an important and preventable cause of health lost to due premature death and disability in Brazil. The findings reinforce the importance of strengthening TB control strategies in Brazil through integrated and multisectoral actions that enable the access to prevention, early diagnosis, and timely treatment, with emphasis on high-risk groups and populations most vulnerable to the disease in the country.

【 授权许可】

CC BY